Children’s Hospital has been designated a Diagnostic Imaging Center of
Excellence® (DICOE) by the American College of Radiology (ACR).
program, which represents the pinnacle of medical imaging care, is an
achievement that goes beyond accreditation to recognize best-quality imaging
practices and diagnostic care. This includes a comprehensive assessment of the
entire medical imaging enterprise, including structure and outcomes.
designation recognizes excellence at multiple levels — including the
professional staff, the technology and the policies and procedures the organization
follows — and superior patient care.
In order to
receive this elite distinction, facilities must be accredited by the ACR in all
modalities they provide, and in which the ACR offers an accreditation program. Another requirement
is to participate in the Dose Index Registry® and General Radiology Improvement
Database, as well as Image Wisely® and Image Gently®.
a full range of specialized pediatric imaging services, including ultrasound,
X-ray, fluoroscopy, MRI and CT scans.
that children don’t need adult levels of radiation, radiation doses on CHOC
equipment can be up to 50 percent lower than at community hospitals or
independent imaging centers.
only board-certified pediatric radiologists and specially trained pediatric
radiology technologists, nurses and child life specialists. Additionally, all
radiology staff undergo age-specific training annually to learn how to work and
communicate with children of varying ages.
is only one of a small number of medical centers in the country to have child
life specialists working in a dedicated pediatric radiology and imaging
founded in 1924, is one of the largest and most influential medical
associations in the United States. The ACR devotes its resources to making
imaging and radiation therapy safe, effective and accessible to those who need
it. Its 38,000 members include radiologists, radiation oncologists, medical
physicists, interventional radiologists and nuclear medicine physicians.
Dozens of staff lined the hallway
making the route from CHOC Children’s Hospital’s pediatric intensive care unit
to its surgical center, offering silent support as a hospital bed came down the
A family followed alongside the bed,
preparing to give the child it carried a last kiss goodbye before their final
act of bravery after a life-ending illness or injury: donating an organ to a
stranger in need.
This somber ceremony is CHOC’s “Walk
of Honor,” a practice designed to honor CHOC families’ courageous and selfless
decision to donate their child’s organs upon their death.
“Our PICU nurses recognize the pain
and loneliness these families feel when leaving the hospital without their
loved one and are determined to make their last walk out a dignified one,” says
Alisa Brown, the PICU’s nurse manager, who helped launch the practice.
As the anniversary of CHOC’s first Walk
of Honor approaches, Alisa will speak later this month at the annual symposium
for OneLegacy, a nonprofit organ donation advocacy group
based in Southern California that works closely with CHOC.
At the upcoming symposium, Alisa will discuss CHOC’s Walk of Honor and
a complementary flag-raising ceremony, and how both have impacted CHOC families
and staff alike.
Support leaving the hospital
The flag ceremony bookends the Walk of
Honor, ensuring that families are supported both when bringing their child to
the operating room and when leaving the hospital to begin a new reality without
After they say their final goodbyes
and their child is pronounced deceased, the family is escorted by CHOC’s team
outside. There, a distinctive flag is raised to commemorate their life-saving
gift. A reading and moment of silence punctuate the ceremony. The family also receives
a flag to take home.
“This is our way of ensuring that
these families are not walking out of the hospital alone and that they are
thanked and honored for their courageous gift before leaving CHOC Children’s
Hospital for the last time,” Alisa says.
The flag flies outside the hospital
for a week, serving as a reminder to all who pass below of a CHOC family’s
“When people see that flag outside, it
reminds us why we’re here,” Alisa says. “It’s easy to get caught up in what’s
going on in our lives, but this puts everything in perspective.”
The PICU’s goal is to provide the
opportunity for organ donation to all families whose child may be eligible.
“One organ donor can save five
different lives and it’s something so healing for these families,” Alisa says.
“It helps with grieving process. It’s just a really powerful thing.”
The Walk of Honor and flag ceremonies are
a small way for CHOC to thank and honor these families and their selfless gift.
Ceremonies are held only with a
family’s permission, and the CHOC team works to make them as personal as
possible. For example, one family’s ceremony included the child’s favorite
“For the families, it changes their
memory,” Alisa says. “A mom told me, ‘You gave me a positive memory from the
worst day of my life.’”
The surprising impact on staff
The ceremonies have had an unexpected
impact on CHOC staff as well.
Processions draw staff from all over
the hospital campus and from a range of disciplines, including clinicians,
dietary workers, environmental services staff and administrative employees.
“After we did the first ceremony, I
had 30 emails and texts from colleagues saying thank you for letting them be
part of it,” Alisa says. “We did this to honor the families and to thank them
for their courageous gift, but it’s turned out to be a huge, impactful thing
for the entire organization. It’s made us more cohesive.”
Both CHOC Children’s Hospital and CHOC
Children’s at Mission Hospital recently earned silver recognition for their
efforts to increase organ, eye, and tissue donor registrations, through the 2019
Workplace Partnership for Life (WPFL) Hospital Organ Donation Campaign.
The WPFL is a national initiative that unites the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), and the organ donation community with workplaces across the nation in spreading the word about the importance of donation.
therapy has been part of CHOC Children’s specialized therapeutic programming
for more than 10 years. The program has grown recently, due to increased
awareness of its effectiveness and a rising need among CHOC patients. We sat
down with Kevin Budd, a board-certified music therapist in CHOC’s Mental Health Inpatient Center, to discuss the benefits
of music therapy in an inpatient psychiatric setting.
Q: What comprises music therapy as a practice?
A: Music therapy is the clinical, evidence-based use of musical interventions to accomplish individualized goals. This occurs within a therapeutic relationship between a credentialed professional who has completed an approved music therapy program and a patient. During music therapy, we address physical, psychological, cognitive and/or social functioning challenges for patients of all ages. Essentially, music is the tool that helps support a patient’s non-musical need.
Q: How does music therapy support clinical goals?
A: A patient’s clinical goal is the starting point for determining which musical intervention will be most effective. In the Center, these goals could include: mood regulation, self-expression, self-esteem, anxiety, interpersonal effectiveness, treatment motivation, positive coping skills and others. There’s no one-size-fits-all treatment when it comes to music therapy and mental health. We might work towards a patient’s goals several different ways, such as through focused music listening, songwriting, song discussion, group instrument playing, music and relaxation, singing and more.
Music therapists rely on assessment, treatment
planning and evaluation to determine whether a patient’s current music therapy methods
are meeting their needs. Without treatment goals, there could be no effective
Q: What is an example of using music therapy to
address a clinical goal?
A: If a patient’s clinical goal is to increase identification of positive coping skills, we might work on lyric analysis within the patient’s preferred style of song. We could discuss triggers, resilience and negative life situations in the song. After this discussion, we could rewrite the chorus of the song, including identification of a negative situation and a positive coping skill to help address it. The patients can then be encouraged to share what they created—by singing, spoken word or other creative means.
this exercise, not only has the patient used a creative medium to identify a
negative situation and how to cope with it; they have also built confidence
after completing and sharing their creation, felt more connected with others in
the group by being vulnerable and feeling validated, improved their mood and increased
their treatment motivation.
What kind of impact have you seen in mental health patients who have
participated in music therapy?
A: Sometimes it’s hard for patients to verbalize past trauma or express their struggles. But with music therapy, they can discuss a song that relates to their current situation—whether it is bullying, family problems, hopelessness, anxiety or another stressor. During this process, patients may be able to process and verbalize more, since the lyrics are an easier gateway for expression.
group ukulele playing, patients who have difficulty with interpersonal
relationships can cohesively and successfully play music together in a positive,
supportive space without the need to talk. They can work on distress tolerance
and problem-solving skills while persevering through a challenging task—and by
the end, they have improved self-esteem.
In any setting, music instantly affects our bodies—mentally,
physically and behaviorally. It’s amazing how one musical intervention can
address multiple goals.
Q: What is unique about music therapy in an inpatient psychiatric
A: Music therapy can look different in the inpatient psychiatric setting than in other areas of the hospital. Within the Center, goals for music therapy are focused on combatting the reasons why a patient is admitted—these could include suicidal ideation, depression, anxiety or other factors keeping a patient from participating in a healthy way in daily life. The goal of the MHIC is to stabilize these patients and provide them with as many resources as possible to cope with their mental health challenges.
therapy does just that and provides opportunities for patients to learn,
process, practice and discover new skills through tailored music interventions.
The MHIC offers opportunities for a diverse group of kids and teens to express
themselves in a supportive, safe and validating environment. Individual music
therapy sessions are available to patients in the Center who need additional
one-on-one support to complement their other treatment.
Q: Why did you want to become a music therapist? Why a mental
health setting specifically?
A: I’ve gone through my own mental health challenges throughout my life, and I always found that music validated my journey. Music helped me distract myself and process my feelings. Music met me where I was in the moment and gave me hope. It also gave me a platform to express myself in ways I didn’t know how to otherwise.
considering career paths, I wanted to find a way to harness the role music had
played in my life in a therapeutic way. After receiving my undergraduate degree
in music, I developed a special interest where psychology and music
intersect—the space where music therapy truly breathes. I pursued my graduate
degree in music therapy and then became a board-certified music therapist.
I feel humbled and fulfilled to be able to support kids and teens at CHOC with the tool of music. By creating an authentic therapeutic alliance, I can support them through a harsh and challenging time in their lives. I am thrilled to be on the front lines of the music therapy program at CHOC Children’s, and I look forward to supporting its growth and success in treating pediatric patients.
patients undergoing treatment for some cancers or blood disorders at CHOC
Children’s have another hope for fertility preservation.
The Hyundai Cancer Institute at CHOC Children’s is the only program on the West Coast offering testicular cryopreservation as an option for young male patients unable to bank sperm but who would like to take steps to preserve future fertility.
program, testicular tissue is biopsied and stored in liquid nitrogen at
temperatures close to absolute zero for future use. Recent research indicates these
biopsies contain stem cells, leading to the possibility of generating sperm in
the future, says Dr. Carol Lin, an oncologist at the Cancer
Institute, and Lisa Klimpel, an oncology nurse practitioner.
among a group of U.S. and Israeli institutions to participate in an eight-year
study wherein a network of centers used standardized protocol and centralized
processing and freezing to collect and store biopsies.
189 patients provided samples. A quarter of each sample was used for research
and the rest stored for future use. These patients ranged from ages 5 months to
34, with an average age of about 8.
published in the journal Human Reproduction, the study, of which Klimpel is a co-author, found that
centralized processing and freezing of testicular tissue from multiple sites is
feasible and could accelerate recruitment.
ago, cancer survivors had few options to have biological children. Today, many
solutions exist, however many oncologists, despite these advancements, still
don’t discuss fertility preservation with their patients, particularly young
At CHOC, however, discussions about fertility preservation with cancer patients early into diagnosis and treatment are a matter of course, as the program works to ensure a meaningful survivorship, says Dr. Lin and Klimpel.